Switching to unboosted atazanavir improves glucose tolerance in highly pretreated HIV-1 infected subjects

Monica Gulffanti, Andrea Caumo, Laura Galli, Alba Bigoloni, Andrea Galli, Geneviéve Dagba, Anna Danise, Livio Luzi, Adriano Lazzarin, Antonella Castagna

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective: To evaluate the 24-week effects on glucose tolerance of switching from a protease inhibitor (PI)-based to an unboosted atazanavir-including regimen in highly pretreated HIV-1 infected subjects with metabolic alterations. Design: Prospective, open-label, single-center, 24-week pilot study. Methods: Twenty-one subjects underwent an oral glucose tolerance test (OGTT) at baseline (BL) and after 24 weeks of unboosted atazanavir. Insulin sensitivity and β-cell responsiveness were evaluated on the basis of static and dynamic data; fasting glucose, insulin, C-peptide, triglycerides (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDI-c), low-density lipoprotein-cholesterol (IDL-c), TC/HDL ratio, CD4+ cell count and HIV-1 RNA were measured. Results: After 24 weeks of unboosted atazanavir, the 120-min glucose level was significantly lower than the one measured at BL (P=0.021); there were no statistically significant differences in the insulin concentration proffie. The SIoral, an OGTT-based index of insulin sensitivity, was significantly higher at week 24 (P = 0.017); the indices of first- and second-phase β-cell responsiveness did not significantly change. There was no significant difference between BL and 24-week fasting glucose, insulin or C-peptide levels and consequently no change in fasting homeostasis model assessment indices of insulin sensitivity and β-cell function. There were significant improvements in TG (P = 0.009), TC (P = 0.0001), LDL-c (P = 0.019) and TC/HDL-c ratio (P = 0.001), and a similar trend in HDT-c levels (P = 0.069). No significant changes in the immunological and virological parameters were detected. Conclusions: Our results show that switching from a PI-based to an unboosted atazanavir-including regimen leads to a significant improvement in glucose tolerance in highly pretreated HIV-1 infected subjects with metabolic alterations.

Original languageEnglish
Pages (from-to)503-509
Number of pages7
JournalEuropean Journal of Endocrinology
Volume156
Issue number4
DOIs
Publication statusPublished - Apr 2007

Fingerprint

HIV-1
Glucose
HDL Cholesterol
Insulin Resistance
Fasting
C-Peptide
Insulin
Glucose Tolerance Test
Protease Inhibitors
Triglycerides
Cholesterol
CD4 Lymphocyte Count
LDL Cholesterol
Homeostasis
Atazanavir Sulfate
RNA

ASJC Scopus subject areas

  • Endocrinology

Cite this

Switching to unboosted atazanavir improves glucose tolerance in highly pretreated HIV-1 infected subjects. / Gulffanti, Monica; Caumo, Andrea; Galli, Laura; Bigoloni, Alba; Galli, Andrea; Dagba, Geneviéve; Danise, Anna; Luzi, Livio; Lazzarin, Adriano; Castagna, Antonella.

In: European Journal of Endocrinology, Vol. 156, No. 4, 04.2007, p. 503-509.

Research output: Contribution to journalArticle

Gulffanti, Monica ; Caumo, Andrea ; Galli, Laura ; Bigoloni, Alba ; Galli, Andrea ; Dagba, Geneviéve ; Danise, Anna ; Luzi, Livio ; Lazzarin, Adriano ; Castagna, Antonella. / Switching to unboosted atazanavir improves glucose tolerance in highly pretreated HIV-1 infected subjects. In: European Journal of Endocrinology. 2007 ; Vol. 156, No. 4. pp. 503-509.
@article{6dd1e02e5ee14a07afec7e3a40fe61da,
title = "Switching to unboosted atazanavir improves glucose tolerance in highly pretreated HIV-1 infected subjects",
abstract = "Objective: To evaluate the 24-week effects on glucose tolerance of switching from a protease inhibitor (PI)-based to an unboosted atazanavir-including regimen in highly pretreated HIV-1 infected subjects with metabolic alterations. Design: Prospective, open-label, single-center, 24-week pilot study. Methods: Twenty-one subjects underwent an oral glucose tolerance test (OGTT) at baseline (BL) and after 24 weeks of unboosted atazanavir. Insulin sensitivity and β-cell responsiveness were evaluated on the basis of static and dynamic data; fasting glucose, insulin, C-peptide, triglycerides (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDI-c), low-density lipoprotein-cholesterol (IDL-c), TC/HDL ratio, CD4+ cell count and HIV-1 RNA were measured. Results: After 24 weeks of unboosted atazanavir, the 120-min glucose level was significantly lower than the one measured at BL (P=0.021); there were no statistically significant differences in the insulin concentration proffie. The SIoral, an OGTT-based index of insulin sensitivity, was significantly higher at week 24 (P = 0.017); the indices of first- and second-phase β-cell responsiveness did not significantly change. There was no significant difference between BL and 24-week fasting glucose, insulin or C-peptide levels and consequently no change in fasting homeostasis model assessment indices of insulin sensitivity and β-cell function. There were significant improvements in TG (P = 0.009), TC (P = 0.0001), LDL-c (P = 0.019) and TC/HDL-c ratio (P = 0.001), and a similar trend in HDT-c levels (P = 0.069). No significant changes in the immunological and virological parameters were detected. Conclusions: Our results show that switching from a PI-based to an unboosted atazanavir-including regimen leads to a significant improvement in glucose tolerance in highly pretreated HIV-1 infected subjects with metabolic alterations.",
author = "Monica Gulffanti and Andrea Caumo and Laura Galli and Alba Bigoloni and Andrea Galli and Genevi{\'e}ve Dagba and Anna Danise and Livio Luzi and Adriano Lazzarin and Antonella Castagna",
year = "2007",
month = "4",
doi = "10.1530/EJE-06-0648",
language = "English",
volume = "156",
pages = "503--509",
journal = "European Journal of Endocrinology",
issn = "0804-4643",
publisher = "BioScientifica Ltd.",
number = "4",

}

TY - JOUR

T1 - Switching to unboosted atazanavir improves glucose tolerance in highly pretreated HIV-1 infected subjects

AU - Gulffanti, Monica

AU - Caumo, Andrea

AU - Galli, Laura

AU - Bigoloni, Alba

AU - Galli, Andrea

AU - Dagba, Geneviéve

AU - Danise, Anna

AU - Luzi, Livio

AU - Lazzarin, Adriano

AU - Castagna, Antonella

PY - 2007/4

Y1 - 2007/4

N2 - Objective: To evaluate the 24-week effects on glucose tolerance of switching from a protease inhibitor (PI)-based to an unboosted atazanavir-including regimen in highly pretreated HIV-1 infected subjects with metabolic alterations. Design: Prospective, open-label, single-center, 24-week pilot study. Methods: Twenty-one subjects underwent an oral glucose tolerance test (OGTT) at baseline (BL) and after 24 weeks of unboosted atazanavir. Insulin sensitivity and β-cell responsiveness were evaluated on the basis of static and dynamic data; fasting glucose, insulin, C-peptide, triglycerides (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDI-c), low-density lipoprotein-cholesterol (IDL-c), TC/HDL ratio, CD4+ cell count and HIV-1 RNA were measured. Results: After 24 weeks of unboosted atazanavir, the 120-min glucose level was significantly lower than the one measured at BL (P=0.021); there were no statistically significant differences in the insulin concentration proffie. The SIoral, an OGTT-based index of insulin sensitivity, was significantly higher at week 24 (P = 0.017); the indices of first- and second-phase β-cell responsiveness did not significantly change. There was no significant difference between BL and 24-week fasting glucose, insulin or C-peptide levels and consequently no change in fasting homeostasis model assessment indices of insulin sensitivity and β-cell function. There were significant improvements in TG (P = 0.009), TC (P = 0.0001), LDL-c (P = 0.019) and TC/HDL-c ratio (P = 0.001), and a similar trend in HDT-c levels (P = 0.069). No significant changes in the immunological and virological parameters were detected. Conclusions: Our results show that switching from a PI-based to an unboosted atazanavir-including regimen leads to a significant improvement in glucose tolerance in highly pretreated HIV-1 infected subjects with metabolic alterations.

AB - Objective: To evaluate the 24-week effects on glucose tolerance of switching from a protease inhibitor (PI)-based to an unboosted atazanavir-including regimen in highly pretreated HIV-1 infected subjects with metabolic alterations. Design: Prospective, open-label, single-center, 24-week pilot study. Methods: Twenty-one subjects underwent an oral glucose tolerance test (OGTT) at baseline (BL) and after 24 weeks of unboosted atazanavir. Insulin sensitivity and β-cell responsiveness were evaluated on the basis of static and dynamic data; fasting glucose, insulin, C-peptide, triglycerides (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDI-c), low-density lipoprotein-cholesterol (IDL-c), TC/HDL ratio, CD4+ cell count and HIV-1 RNA were measured. Results: After 24 weeks of unboosted atazanavir, the 120-min glucose level was significantly lower than the one measured at BL (P=0.021); there were no statistically significant differences in the insulin concentration proffie. The SIoral, an OGTT-based index of insulin sensitivity, was significantly higher at week 24 (P = 0.017); the indices of first- and second-phase β-cell responsiveness did not significantly change. There was no significant difference between BL and 24-week fasting glucose, insulin or C-peptide levels and consequently no change in fasting homeostasis model assessment indices of insulin sensitivity and β-cell function. There were significant improvements in TG (P = 0.009), TC (P = 0.0001), LDL-c (P = 0.019) and TC/HDL-c ratio (P = 0.001), and a similar trend in HDT-c levels (P = 0.069). No significant changes in the immunological and virological parameters were detected. Conclusions: Our results show that switching from a PI-based to an unboosted atazanavir-including regimen leads to a significant improvement in glucose tolerance in highly pretreated HIV-1 infected subjects with metabolic alterations.

UR - http://www.scopus.com/inward/record.url?scp=34247629373&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34247629373&partnerID=8YFLogxK

U2 - 10.1530/EJE-06-0648

DO - 10.1530/EJE-06-0648

M3 - Article

VL - 156

SP - 503

EP - 509

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

SN - 0804-4643

IS - 4

ER -